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Nursing Week Nightingale Award: Nurse of the year relies on real tact and empathy

Public health nurse Lisa Gillespie helped make Woodstock, one of only five Ontario sites to offer a harm reduction program designed to prevent opiode drug users from dying of overdose.

Lisa Gillespie, RN, RPN is the Toronto Star’s Nightingale Award winner for Nurse of the Year. She led the development of Oxford County’s leading overdose prevention program for high risk opioid drug users.
(Peter Power / for Toronto Star)

Public health nurse Lisa Gillespie’s contact with patients is often fleeting at the needle exchange and sexual health clinic where she practices in Woodstock, Ont.

But in that setting, even brief encounters can be life-altering.

So moments matter.

For Gillespie, one of those moments occurred in March.

She was working with a client in a ground-breaking harm-reduction program she helped launch this year at Oxford County Public Health and Emergency Services.

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The program “Take Home Naloxone” teaches people who are at risk, how to recognize and treat an overdose.

The drug user is given a life-saving kit that includes a prescription for the opioid antidote Naloxone. Opioids include drugs such as heroin, morphine, methadone or oxycodone (contained in OxyContin).

A nurse teaches the drug user how to inject the antidote by practicing with an ampule of sterile water and a muscle simulator. The client also learns to do chest compressions, rescue breathing and call 9-1-1 as the Naloxone only arrests the overdose for 60 to 90 minutes.

Gillespie was teaching these skills to one of nine clients who have received the training in Woodstock so far.

What he told her, she says, “was probably the best moment in my career to date.”

The man said that he had been planning to stay home that day and get high. Instead, he had learned to save a life. The empowerment he felt — “That’s exactly what I want,” she said.

Gillespie, who sits on the Oxford Drug Task Force, heard about the program at a conference about two and a half years ago. She went home and began seeking buy-in for an overdose prevention program.

“From the needle exchange program, I knew the drug of choice was opiates and most specifically Oxycontin and I knew people were dying from drug overdoses. I wanted to increase awareness of the issue and how to prevent overdose in the first place,” she said.

In a rural community, Gillespie felt it was vital to get the buy-in of police and emergency services. She credits a supportive supervisor and a medical directive from the Oxford medical officer of health with helping make Woodstock one of five provincial health departments to offer the program.

Providing addicted clients with an injectable drug is inevitably controversial — a bit like distributing condoms to kids, whose parents would prefer they weren’t sexually active.

“A lot of people don’t understand harm reduction. They think we’re enabling. When people become aware of us, we’re often having to defend what we do,” said Gillespie, 44.

She considers herself a sensitive listener. Twelve years into her public health role, however, Gillespie still struggles with a fear of public speaking, whether she is addressing other professionals or offering a Grade 7 class some straight talk on sex.

She has, nevertheless, harnessed her voice to be a powerful advocate for harm-reduction, says her colleague, nurse practitioner Mary VandenNeuker, who nominated this year’s Toronto Star Nightingale Award winner.

The award is presented annually to an Ontario nurse recognized by her or his patients or peers. The recipient and honourable mentions are selected by a panel of representatives from Ontario nursing associations and the Toronto Star. More than 170 nurses were nominated for this year’s award.

VandenNeuker, who describes Gillespie as non-judgmental and compassionate, was moved to write a nomination letter after hearing her talk about a client.

“It was just the way (Gillespie) brought that forward for all of us, to recognize there’s a story behind all these individuals, how (they) live every day. They’re very resilient and they’re able to carry on even though they carry so much baggage, and, how that little bit of interaction with people who care can make such a difference in their lives,” said VandenNeuker.

The Oxford County public health unit is housed in the old Woodstock jail. The immaculate examining rooms in the clinic feature tiny, recessed windows near the high ceilings. Metal bars act as a transom over a doorway. The heavy wood doors face a treed park fronted by gracious old homes. But the pretty town of about 40,000 (Oxford County has a population of more than 100,000) has its own share of poverty, unplanned pregnancies and addiction.

“I don’t think there’s any community in Ontario that’s immune to that problem,” said Gillespie.

Opioid overdose is a major cause of accidental death in Ontario. She said it gets scant attention because of the people it affects, who are often marginalized.

When it comes to addiction, there is lots of blame and moralizing, said Gillespie, but it has no place in the treatment of a complex disease.

“I believe addiction is a medical concern and morality should stay out of it. It’s just like diabetes or any other chronic disease; we need to treat people with empathy and compassion,” she said.

It takes very little, she added, citing an instance in which she simply asked a man at the needle exchange how he was doing one day.

“That’s the nicest thing anyone’s said to me this week,” he told her.

Some clients only spend a couple of minutes filling out a form and obtaining sterile equipment. Sometimes nurses – Gillespie is one of four in Woodstock – refer clients to soup kitchens or shelters, or, they will make calls for people who are simply too overwhelmed to pick up the phone themselves.

Gillespie remembers making a call to help a client get a health card.

“Now he can get methadone treatment and he’s on the road, hopefully, to recovery. We know relapse is a possibility, but I personally have not seen that guy come back. But he made a point of coming back and thanking me just for that phone call.

Raised on a farm near Fergus, Ont., in a family of teachers, Gillespie credits her mother for nudging her to a nursing career. As a teen, Gillespie worked in the local hospital kitchen, pushing the drink cart and chatting with patients in the evening. She loved it.

She trained first at Mohawk College and later at Ryerson University and has worked in several hospitals, including St. Michael’s in Toronto, mostly in cardio care. Gillespie admits she still occasionally misses the life-or-death moments of running down the hall with a crash cart, as well as the opportunity to bond with patients at the bedside.

She never expected to work at a needle-exchange and sexual-health clinic. But when the first of her two children was born, she turned to public health as a way to continue her nursing career with more family-friendly shifts.

“I have to say that, going into nursing, I never would have expected to be doing this work. I don’t think I even knew this work existed,” she said.

“Now I can’t imagine doing anything else.”

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